Child sexual abuse

Factors Associated With Contact Sexual Offending Among a Non-Forensic Sample of Women With Sexual Interest in Children - Results From an Anonymous Online Survey

This study aimed at assessing the extent to which factors associated with male child sexual offending may also be applicable to women with a self-identified sexual interest in children. Participants (n = 42) took part in an anonymous online survey covering questions about general characteristics, general sexuality, sexual interest in children, and previously-perpetrated contact child sexual abuse. Group comparisons between women who reported committing contact child sexual abuse compared to those who had not were conducted in terms of sample characteristics. Furthermore, the two groups were compared regarding the factors of high sexual activity, use of child abuse material, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, emotional congruence with children, and childhood maltreatment. Our results revealed that high sexual activity, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, and emotional congruence with children were associated with previous contact child sexual abuse perpetration. We recommend further research on potential risk factors relating to child sexual abuse on the part of women.

Trauma and Incarceration: A Latent Class Analysis of Lifetime Trauma Exposures for Individuals in Prison

This paper aims to contribute to the knowledge base about the lives of individuals who experience incarceration in the U.S. in order to advance post-release intervention services. Research has shown that among the millions of Americans who cycle through prisons and jails each year, the majority are poor, in poor health, living in contexts of chronic violence, often with mental illness, and more than half are people of color. Of particular concern for this population are high rates of trauma exposure and PTSD, though the research in this area is underdeveloped, particularly for men. Using survey data gathered during a large (n = 1,516, 90% male) multi-state randomized control trial of a reentry intervention, this study used latent class analysis (LCA) to explore types and timing of trauma exposures across the life course. LCA has been found to be an effective statistical tool in intervention research for identifying high-risk groups and for informing the tailoring of interventions. This study found three latent classes: 1) Lifetime Interpersonal Polyvictimization, 2) Lifetime Environmental Exposures, and 3) Low Exposure. About one third of the sample fell within each class. Study findings indicate that not only should trauma-informed and trauma-specific interventions be the norm in reentry services, including for men, but that these interventions should target both individual and environmental factors.

The effect of childhood sexual abuse on depressive symptoms in female college students: a serial mediation model

Objective

Childhood sexual abuse (CSA) can have a negative impact on women's psychological, emotional and social functioning. The purpose of this study was to explore the relationship between CSA and depressive symptoms in female college students, as well as the mediating roles of negative core schema and experiential avoidance.

Methods

515 female college students responded to the Sexual Abuse subscale of the Childhood Trauma Questionnaire, the Depression subscale of the Depression Anxiety Stress Scale, the Brief Core Schema Scales, and the Acceptance and Action Questionnaire - II. The structural equation modeling was used for the mediation analysis.

Results

There was a significant positive correlation between CSA and depressive symptoms in female college students. The theoretical model was well fitted, χ2/df = 3.422, RMSEA = 0.069, CFI = 0.929, TLI = 0.919. The negative core schema played a mediating role between CSA and depressive symptoms. Experiential avoidance played a mediating role between CSA and depressive symptoms. The negative core schema and experiential avoidance played a serial mediating role between CSA and depressive symptoms.

Conclusion

These results deepen our understanding of the relationship between CSA and depressive symptoms in female college students, and provide theoretical guidance for the prevention of depression in female college students. Attention should be paid to female college students who have experienced CSA, to eliminate the adverse influence of negative core schema on these students. Meanwhile, we should teach female college students to accept themselves as they are, and thereby reduce their use of experiential avoidance strategies.

The relationship between childhood maltreatment and non-suicidal self-injury in adolescents with depressive disorders

This study aims to explore the core symptoms of Non-Suicidal Self-Injury (NSSI) in adolescents with depressive disorders and the relationship between childhood maltreatment (CM) and NSSI symptoms by using network analysis. A total of 689 adolescents with depressive disorders participated in the survey. The Chinese version of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ) and the Short Form of the Childhood Trauma Questionnaire (CTQ-SF) were employed to measure NSSI and the symptoms of CM, respectively. Using network analysis, the NSSI network and the CM-NSSI network were constructed to identify the most central symptoms and the bridge symptoms within the networks. Within the NSSI network, "Intentional scratches", " Intentionally hitting hard objects with your head ", " Intentionally hitting oneself with fists or harder objects ", and " Intentional pinching " were identified as the primary symptoms of NSSI. "emotional abuse", "sexual abuse", and " Intentionally cut yourself " emerged as three key bridge symptoms linking CM with NSSI. This research is the first to investigate the symptom network of CM-NSSI in a sample of adolescents with depressive disorders, providing a foundation for subsequent NSSI prevention and the development of targeted intervention strategies.

Livestreaming Technology and Online Child Sexual Exploitation and Abuse: A Scoping Review

Livestreaming of child sexual abuse (LSCSA) is an established form of online child sexual exploitation and abuse (OCSEA). However, only a limited body of research has examined this issue. The Covid-19 pandemic has accelerated internet use and user knowledge of livestreaming services emphasizing the importance of understanding this crime. In this scoping review, existing literature was brought together through an iterative search of eight databases containing peer-reviewed journal articles, as well as grey literature. Records were eligible for inclusion if the primary focus was on livestream technology and OCSEA, the child being defined as eighteen years or younger. Fourteen of the 2,218 records were selected. The data were charted and divided into four categories: victims, offenders, legislation, and technology. Limited research, differences in terminology, study design, and population inclusion criteria present a challenge to drawing general conclusions on the current state of LSCSA. The records show that victims are predominantly female. The average livestream offender was found to be older than the average online child sexual abuse offender. Therefore, it is unclear whether the findings are representative of the global population of livestream offenders. Furthermore, there appears to be a gap in what the records show on platforms and payment services used and current digital trends. The lack of a legal definition and privacy considerations pose a challenge to investigation, detection, and prosecution. The available data allow some insights into a potentially much larger issue.

Child sexual abuse prevention: A qualitative study of teachers' educational needs

Background

Child sexual abuse (CSA) has emerged as a global concern, particularly affecting children in Indonesia. However, there remains a scarcity of research on CSA within the Indonesian context.Objective: This study aimed to explore the educational needs of primary school teachers in preventing child sexual abuse.

Methods

A qualitative descriptive study design was employed, with eight teachers and school principals selected through purposive sampling. Data were collected through focus group discussions and analyzed using content analysis.

Results

Six categories emerged: 1) The risk of sexual abuse, 2) The necessity for clear CSA preventive regulations and sanctions for abusers, 3) Lack of CSA program socialization, 4) The need for structured CSA prevention education for children, 5) The importance of effective coordination with various relevant stakeholders, and 6) The presence of barriers and obstacles.

Conclusion

This study provides valuable insights into the educational prerequisites for teachers to implement CSA prevention measures effectively. The findings emphasize the pressing need for school teachers to develop and implement CSA prevention programs, with the government's and nursing professionals' support, to enhance educators' abilities in combating CSA. Nurses have a pivotal role in preventing and addressing child sexual abuse, and they should actively contribute to improving child safety and well-being through knowledge, collaboration, and advocacy for comprehensive prevention strategies.

Access to therapy for child sexual abuse survivors: Preliminary dialogue of barriers and facilitators between caregivers

BACKGROUND

Difficulties in access to therapy were highlighted by COVID-19 measures restricting in-person gatherings. Additional challenges arise when focusing on caregivers of child sexual abuse (CSA) survivors in particular, which are a population that has been historically difficult to engage with due to issues of stigma and confidentiality.

OBJECTIVES

To present preliminary qualitative results from caregivers of CSA survivors.

METHODS

This study was conducted with caregivers of CSA survivors. Two hybrid webinar/focus groups were conducted using a video conferencing platform in fall of 2021 with two groups of stakeholders (11 caregivers and 5 moderators/clinical staff at Little Warriors, an intensive episodic treatment facility). Sessions were recorded, transcribed, and thematically-analyzed using standard qualitative methodology.

RESULTS

A total of 11 caregivers contributed to the data. Themes include: (1) Challenges of starting and maintaining treatment (i.e., emotional impact of intake day, challenges of enrolling), (2) Therapeutic benefits of specialized treatment (i.e., feeling safe and supported and the importance of trauma-informed care), and (3) Barriers and facilitators of treatment (i.e., avenues to scale-up and self-care).

CONCLUSION

The importance of a strong therapeutic alliance was highlighted by both caregivers/clinical staff and further support is needed for families post-treatment. The present hybrid webinar/focus group also achieved engagement goals in a population that is typically difficult to reach. Overall, the response rate (12%) was equivalent to reported registrant attendance rates for general business to consumer webinars and the recommended focus group size. This preliminary approach warrants replication in other populations outside our clinical context.

Childhood trauma and bipolar affective disorder: Is there a linkage?

Bipolar affective disorder (BPAD) is a major psychiatric illness impairing the quality of life. The etiology of BPAD is influenced by different factors possibly related to gene-environment interactions. Approximately 30% to 50% of individuals with BPAD have experienced some traumatic event in childhood. Serious adverse experiences that children may suffer early in life are often described as childhood trauma (CT). It includes physical, emotional, and sexual abuse and physical and emotional neglect. CT is linked with an elevated risk of developing BPAD. Childhood adversities play a role in modulating the early onset of illness, increased number of depressive episodes, increased suicide attempts, and other clinical severity of BPAD. Hospital-based studies comprising heterogeneous populations had researched the specific role of each trauma subtype as a predisposing factor for BPAD. Identifying and addressing CT through early intervention methods may prevent the future development of chronic disorders like BPAD. This review article is an attempt to explore and highlight the existing literature regarding the association of different subtypes of CT with BPAD.

Relationship Between Childhood Trauma and Nonsuicidal Self-Injury Among Adolescents with Depressive Disorder: Mediated by Negative Life Events and Coping Style

Purpose

Nonsuicidal self-injury (NSSI) is related to childhood trauma, negative life events, and coping style, but the interaction among these factors and the mechanism by which they interact in adolescents with depressive disorder remain unclear. This paper explores how these factors interact to influence NSSI and provides evidence to develop prevention efforts and interventions for adolescents with depressive disorder with NSSI.

Patients and Methods

A cross-sectional design and convenient sampling method were used in this study. The Childhood Trauma Questionnaire, Adolescent Self-Rating Life Events Checklist, Trait Coping Style Questionnaire, and Adolescent Nonsuicidal Self-injury Assessment Questionnaire were completed by 540 adolescents with depressive disorder. Descriptive analysis, chi-square tests, t-tests, Pearson correlations, and serial mediation analyses were used in the data analysis.

Results

A total of 398 (79.442%) adolescents with depressive disorders reported experiences of NSSI. The results of serial mediation analyses determined that childhood trauma has a direct (estimate = 0.209, 95% CI: 0.063, 0.334) and indirect (estimate = 0.271, 95% CI: 0.199, 0.371) impact on NSSI. The indirect impact of childhood trauma on NSSI through negative life events alone (estimate = 0.096, 95% CI: 0.007, 0.169), coping styles alone (estimate = 0.088, 95% CI: 0.034, 0.183), and negative life events on coping styles (estimate = 0.086, 95% CI: 0.042, 0.162) was significant.

Conclusion

This study demonstrates that screening for childhood trauma should be considered when preventing and treating NSSI behavior in adolescents with depressive disorder. Managing negative life events and coping style may mitigate the negative impact of childhood trauma on NSSI behavior in adolescents with depressive disorder.

Toward a Global Definition and Understanding of Child Sexual Exploitation: The Development of a Conceptual Model

Child sexual exploitation (CSE) is a serious and persistent global issue affecting up to 5% of the child and youth population worldwide; yet there is no universally accepted definition. To develop a theoretically robust definition of CSE, this review systematically synthesized literature examining CSE definitions aiming to develop a conceptual model and typology. Electronic databases were searched to February 2021, yielding 384 nonduplicative records. Inclusion criteria were peer-reviewed and grey literature investigations of sexual exploitation, with a mean sample age of 18 years or younger, available in the English language. Literature review and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sixty-six studies met final inclusion criteria. Two independent reviewers extracted relevant data and used an epistemological approach to thematically analyse meaning and patterns across CSE definitions. Key findings demonstrate that CSE nomenclature is widely inconsistent, and despite growing awareness of this severe form of abuse, language continues to perpetuate stigma and criminalisation, utilising terms such as 'adolescent or child prostitute'. Our findings propose a scientifically and trauma-informed definition and conceptualisation of CSE, based on the following four-dimensional components: (1) A child/young person; (2) sexual acts; (3) abuse; and (4) exploitation (abuse + exchange). In this systematic review, a unified definition and conceptual model aims to advance knowledge and understanding of CSE, contributing to the progression of social norms which embrace nuances of trauma-informed practice and support for the identification and recovery of children, young people and families affected by sexual exploitation.

Enhancing children's awareness of sexual abuse in Pakistan with video literacy interventional cartoons

In presence of violent extremism, children in Pakistan are at high risk for child sexual abuse (CSA), especially after the COVID-19 pandemic. Effective approaches for preventing CSA include enhancing resilience resources in violence-affected societies. Previous research suggests that video-based curricula effectively enhances learning in primary schoolchildren. We pilot tested a video literacy program to build awareness in children, creating a 'personal safety and space bubble' as an educational approach for prevention of sexual abuse with an experimental 6 weeks long pre- and post-test design. We conducted qualitative interviews with students, teachers, and parents and identified themes using frequency analyses. Results showed a 96.7% increase in awareness about 'personal safety and space bubble'. The pilot study is valuable for public health researchers and policy makers seeking to curtail sexual abuse in extreme violence affected Pakistan. Primary schools can use such interventional cartoons to enhance awareness about child sexual abuse.

Child sexual abuse in Kaduna State, Northwestern Nigeria: A review of 420 police-reported cases

Child sexual abuse affects millions of children globally but in Nigeria, hospital-based studies continue to report few cases, making it difficult to assess the magnitude and quality of care. This study aimed to overcome this challenge by reviewing police medical reports instead of hospital records. A total of 420 reports were retrieved from one police area command in Kaduna State, Northwestern Nigeria, between 2018 and 2021. The majority of the victims were females (65.5%), 5-14 years (70.2%), and familiar with their assailants (71.4%). Most of the assailants were men (99.0%), 20-40 years (29.1%), who acted alone (86.7%). Most of the reports contained history (79.3%), physical examination (49.6%), and laboratory results (>90%). Among female victims, the commonest genital findings were absent hymen (25.6%) and normal findings (17.6%). Among male victims, the commonest anal findings were normal findings (41.7%) and anal dilatation (23.6%). The victims tested positive for HIV (0.5%), hepatitis B (4.7%), hepatitis C (1.0%), and syphilis (0.8%). Higher positivity rates were noted among assailants. Treatments offered to the victims included antibiotics (30.2%), analgesics (11.9%), emergency contraception (6.7%), and psychotherapy (67.4%). The review calls for improved reporting, use of comprehensive treatment guideline, and training of service providers to improve the quality of care.

A Cross-Sectional Study on Public Awareness About Child Sexual Abuse in Makkah, Saudi Arabia

BACKGROUND

Child sexual abuse is a very serious and dangerous problem. It has long-term consequences and may impact children and follow them into adulthood. Without exception, regardless of their cultures and religious beliefs, all communities are vulnerable to child sexual abuse (CSA).

OBJECTIVE

Our aim in this study is to assess the level of public (caregivers) awareness of CSA in Makkah and Jeddah, Saudi Arabia.

METHODOLOGY

A cross-sectional study was conducted in Makkah and Jeddah. The target populations were Saudi parents, caregivers, and teachers who are in daily contact with children. The participants were selected randomly (n=417), and were requested to complete a questionnaire that was later analyzed using the IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.

RESULTS

369 from 417 responders were females (88.5%), while 48 were males (11.5%). About 90.2% of the responders acknowledged the existence of the child sexual abuse problem. About 95.7% of the caregivers were aware of physical, social, and psychological consequences of child sexual abuse. In contrast, only 33.8% of the responders were aware of existence of social agencies and organizations that provide supportive services to the victims of child sexual abuse.

CONCLUSION

In conclusion, the study found a high rate of awareness in the caregivers who recognize the problem of child sexual abuse (CSA) and are aware of its magnitude and impact on children's well-being. However, these results demonstrate the need for more education of the public about the mandatory laws regarding child sexual abuse.

Co-occurrence of PTSD and affective symptoms in a large sample with childhood trauma subtypes: A network analysis

Background

Exposure to childhood trauma (CT) is associated with various deleterious mental health outcomes, increasing the risk of suicidal behaviors. The objective of this study is to investigate the different effects of three forms of CT, including emotional abuse (EA), physical abuse (PA), and sexual abuse (SA), on potential psychopathological symptoms among college students.

Methods

A total of 117,769 students from 63 Chinese colleges participated in this study. There were 1,191 participants in the EA group (1.24%; 95% CI: 1.17-1.31%), 1,272 participants in the PA group (1.32%; 95% CI: 1.25-1.40%), and 3,479 participants in the SA group (3.62%; 95% CI: 3.50-3.73%). CT was measured by the Childhood Trauma Questionnaire-Short Form. Psychopathological symptoms (i.e., depression, anxiety, and PTSD) were measured by the PHQ-9, GAD-7, and Trauma Screening Questionnaire, respectively. Network analysis was applied to analyze psychopathological symptoms between three CT subgroups (EA, PA, and SA). The associations and centralities of the networks were calculated, and the network characteristics of the three subgroups were contrasted.

Results

The main symptoms across all three groups are uncontrollable worry, sad mood, irritability, and fatigue, which indicates these core symptoms play essential roles in maintaining the whole psychological symptoms network. Furthermore, there are significant differences in symptom associations between the three groups. The comparison of network structures of the three groups shows that the SA group reports more PTSD symptoms, the EA group reports more suicide-related symptoms, and the PA group reports more anxiety symptoms.

Conclusion

Specific symptoms were disclosed across each group by the distinctive core psychopathological symptoms found in the CT subgroup networks. The present study's findings show different associations between CT and psychopathology and may help classify potential diagnostic processes. Therefore, local governments and academic institutions are recommended for early intervention to promote the psychological well-being of CT survivors.

The impact of childhood sexual abuse and its associated stigma on depressed women in Egypt

Background

Depression is common in women, childhood sexual abuse and its related stigma in our culture are expected to increase the severity of depression, and it may be a strong risk factor for the presence of suicidal ideations in women. This study aimed to look at the relationship of childhood history of sexual abuse and its related stigma to depression and suicidal ideations in depressed women.

Methods

A consecutive sample of 160 depressed women was enrolled in this study. The structured clinical interview for DSM-5 was used to diagnose depression, and the Beck Depression Inventory, second edition was used to quantify its severity. The Scale for Suicidal Ideations was used to evaluate suicidal ideations, and history taking was used to assess previous suicidal attempts. The history of childhood sexual abuse was evaluated using a self-report questionnaire, the questions of this questionnaire were derived from the National Population Survey, and a Canadian survey of sexual abuse and its related stigma was assessed using a scale for stigma of sexual abuse.

Results

The findings showed that 11.8% of depressed women had a history of childhood sexual abuse under age of 15 years. There was a significant decrease in age of onset of depression, a significant increase in duration of depression, number of hospital admission, the Beck Depression Inventory, second edition BDI-II, the Beck Hopelessness Scale (BHS) mean scores, number of patients with suicidal ideations, and previous suicidal attempts in depressed women with a history of childhood sexual abuse in comparison to those without that history. History of childhood sexual abuse and its related stigma were the most significant predictors for the presence of depression and current suicidal ideations.

Conclusions

The history of sexual abuse in childhood and its related stigma were associated with increased severity of depression and the presence of suicidal ideations in depressed women. Identification of childhood sexual abuse and its related stigma in depressed women is highly important for proper management of depression.

Prevalence of Child Sexual Abuse in Spain: A Representative Sample Study

The prevalence of child sexual abuse (CSA) is difficult to assess, and rates vary widely across studies due to methodological and sample differences. In Spain, prevalence data from representative samples are lacking. The objective of this study was to determine the prevalence of different CSA experiences in a sample that was representative of the Spanish population in terms of gender, age, and region. The sample comprised 1,071 (539 male and 532 female) Spanish adults (M_age = 45.37; SD = 14.84). Participants completed an anonymous online survey about different types of CSA and were asked whether they had disclosed the experience at the time. Prevalence was analyzed as a function of gender and generation. Results indicated prevalence rates ranging from 2.8% to 18.5%, depending on the type of experience. The most common experience suffered during childhood was being shown pornographic material, while that with the lowest prevalence was being forced to perform a sexual act involving penetration. Prevalence was higher in females than males for eight of the ten experiences considered. Young adults from Generation Z were the most likely to report having suffered three of the CSA experiences, two of them related to technology. Only 27.5% of respondents said that they had told someone about the abuse at the time, mainly their mother (more common among females) or a friend/peer (more frequent among males). The results suggest that CSA is prevalent in Spain, with considerable rates for several types of abusive experience, especially among females and the youngest generation. The implications of the results are discussed. The findings may inform social policy and the development of effective prevention programs.

Prevalence of Child Contact Sexual Abuse in the Spanish Region of Andalusia

The aim of this study was to analyze the prevalence and characteristics of child sexual abuse (CSA) in Andalusia, Spain's most populated region. A sample of 817 adults (281 male; M age = 34.7; SD = 13.86) completed the Child Sexual Abuse Experiences Questionnaire. Because the sample was unbalanced, we performed post-stratification by gender, resulting in 562 participants (50% male). Overall, 38.8% of the sample reported at least one type of contact abuse experience, with prevalence ranging from 22% for being fondled to 3.9% for being forced to perform a sexual act involving penetration. The first episode of CSA most commonly occurred between age 6 and 11 years, except for penetration. The majority of reported experiences were repeated and perpetrated by a male. More than half of the victims did not label their experience as sexual abuse, and this apparent lack of awareness about what constitutes abuse was particularly evident among male victims. The prevalence of CSA in Andalusia is higher than for Spain as a whole, highlighting the need to raise public awareness through prevention programs.

Treatment and Therapeutic Change of Individuals Imprisoned for Child Abuse in the Barcelona Study on Sex Offenders

The sexual abuse of children is a serious social problem that must be prevented through distinct measures. Among them is the application of treatments to those who have already committed sex crimes in order to prevent them from committing a new one. To assess the efficacy of sexual offense treatment, the most common method has been to compare the recidivism rates of treated and untreated groups. Several meta-analyses in this regard-as well as some specific studies in Spain-have shown that the application of treatment is associated with lower recidivism rates. However, the analysis of the subjects' recidivism alone does not reveal the therapeutic changes that the treatment may elicit in them. Some international studies have evaluated the therapeutic improvements resulting from the application of treatments to men who had sexually abused children. In this context, this study explores the therapeutic changes experienced by a sample of subjects imprisoned for child abuse (N = 145), after participating in the treatment program applied in the Spanish prison system. Nine therapeutic variables were assessed (such as anxiety, cognitive distortions, impulsivity, and social self-esteem), before and after treatment, using an instrument named the Psychological Assessment Scale for Sex Offenders (PASSO). The obtained results show that most of the assessed therapeutic variables improved after treatment, with strong correlations between them. The implications of the results for treatment practice are discussed, as well as the main methodological limitations of this research.

The Lived Experience of Human-Pet Relationships among Adult Survivors of Childhood Sexual Abuse: An Interpretative Phenomenological Analysis

Given the high prevalence and severe consequences of childhood sexual abuse, it is essential to identify ways to support adult survivors. One potential and relatively unexplored resource available to survivors is the human-pet relationship. In the literature, the human-pet relationship is linked to many positive benefits to physiological regulation, mental health, physical health, and social support - areas of functioning where survivors of childhood sexual abuse may be particularly at risk. Despite existing evidence, there is little research on human-pet relationships among survivors of childhood sexual abuse. To help address this gap, this qualitative study explored the lived experience of human-pet relationships among adult survivors of childhood sexual abuse. Utilizing data collection and analysis methods from Interpretative Phenomenological Analysis, semi-structured interviews were conducted with 10 adult survivors of childhood sexual abuse. The following themes were developed from the data: (a) close bond with pet; (b) idiosyncrasies within the human-pet relationship; (c) moral responsibility; (d) fundamental differences between pets and humans; (e) safety in the human-pet relationship; (f) resource for coping with painful experience; (g) positive impact on well-being; (h) buttress for human-human social interaction; (i) medium for skill and knowledge development; and (j) shortcomings of the human-pet relationship. Findings are discussed in the context of the existing literature, along with considerations for practice and future research with childhood sexual abuse survivors.

Stigma, epistemic injustice, and "looked after children": The need for a new language

This article examines the processes that contribute to the stigmatization of a group of people typically identified as "children in care" or "looked after children." In particular, we will look at the ways that we (adults, professionals, and carers) interact with these children, based on their status as both children and members of a socially marginalized and disadvantaged group, and how these modes of interaction can inhibit dialogue-a dialogue that is needed if we are to base our conceptions regarding the needs of these children on a more accurate understanding of their experiences and perspective. The problem is particularly challenging because the very terminology we use in the care community to identify this group is a product of the damaging preconceptions that have affected our interactions with its members and, we argue, it serves to reinforce those preconceptions. Using Fricker's work on epistemic injustice, in conjunction with evidence regarding how accusations of abuse and neglect of these children have been addressed in numerous cases, we illustrate the problems we have in hearing the voices of members of this group and the harmful effects this has on their own ability to understand and articulate their experiences. These problems represent "barriers to disclosure" that need to be surmounted if we are to establish a more inclusive dialogue. Currently, dialogue between these children and those of us charged to "look after" them is too often characterized by a lack of trust: not only in terms of the children feeling that their word is not taken seriously, that their claims are not likely to be believed, but also in their feeling that they cannot trust those to whom they might disclose abuse or neglect. The goals of the paper are modest in that we aim simply to open up the debate on how to meet this epistemic challenge, noting that there are specific problems that extend beyond those already identified for hearing the voices of other victims of epistemic injustice. Explicitly recognizing the nature and extent of the problem still leaves us a long way from its solution, but it is a crucial start.

A study on child sexual abuse reported by urban indian college students

Background and Objectives

The prevalence of child sexual abuse (CSA) in India is 18-50% depending on the population studied. To devise strategies for prevention of CSA at the primary care level, we studied the prevalence of CSA amongst college students aged 17-25 years.

Methods

A group of medical students and their friends were sent, an anonymous questionnaire validated by experts via WhatsApp. The questionnaire assessed demography, occurrence of prior CSA and details of the sexual abuse.

Results

About 574 students participated in the study. The majority of respondents were female (380, 66.2%). About 467 (81.2%) of participants were from South India. Of the 380 women and 194 men who consented to participate in the study, 218 (57.3%) and 65 (33.5%), respectively, said that they had been sexually abused in the past (p < 0.00001). The event commonly occurred at 12-14 years (22.6%), but about 53% of victims were <12 years of age. The perpetrator was usually male (93.2%), less than 30 years of age (54%) and a stranger (42.7%). The most common form of CSA from 348 instances in 283 respondents was some form of "bad touch or caresses" (56.6%). About 25.8% of those abused did not speak to anyone about the event. Only 249 respondents (43%) were counselled regarding CSA by their parents.

Conclusions

The prevalence of CSA amongst South Indian college students is 49.3%. The victims were mainly girls <12 years of age and the perpetrators were mainly male (93.2%). Primary Care Physicians can play a greater role in the early detection and prevention of CSA.

STAIR Plus Narrative Therapy-Adolescent Version (SNT-A) in An 11-Year-Old Girl With PTSD and Suicidal Behaviors Following Rape/Sexual Assault: A Case Report

Rape/sexual assault can profoundly affect the physical, mental, and social well-being of victims. Post-traumatic stress disorder (PTSD) and suicide in rape/sexual assault survivors are significantly more frequent than the national prevalence of the condition, indicating that existing treatments require improvement. In this case report, we presented an 11-year-old Iranian girl with PTSD and suicidal behaviors following rape/sexual assault. We specifically focused on the process of helping the victim to develop effective coping skills and overcome the trauma through 16 weekly sessions of Skill Training in Affective and Interpersonal Regulation (STAIR) plus Narrative Therapy-Adolescent Version (SNT-A). During this therapeutic approach, the patient regained emotional control over the traumatic experience and made sense of the experience. Our findings revealed that SNT-A might be an effective intervention to reduce suicidal ideation among adolescent victims of rape/sexual assault. Nonetheless, further investigations in this field need to be carried out through randomized controlled trials.

Stolen innocence: Dishonor and taint in times of war

As soon as they are taken prisoner, children and adolescents in times of war are inserted into a spiral of cruelty that progresses to rape or other countless forms of physical and psychological torture using sex as a weapon. Were these children and adolescents war sex slaves? Oral sex and other sexual barbarities are part of spaces of abuse and humiliation. The damage to the personality structure of these children and adolescents is severe. The psychological consequences are numerous. Over the years, a vicious circle has been observed around this brutality.

Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review

INTRODUCTION

The term "paedophilia erotica" was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a "psycho-sexual perversion." It was at the beginning of the twentieth century that the term "pedophilia" was adopted and it started to appear in medical dictionaries. Sexual abuse is legally defined as the engagement in sexual contact with a person below a specified age or who is incapable of giving consent. Both, pedophilia and child sexual abuse (CSA) are worldwide phenomena requiring deep scientific knowledge in order to improve prevention strategies. Individuals' misconceptions of pedophilia and CSA may legitimize sexual violence, which can influence prevention strategies and policies.

OBJECTIVES

This review aimed to summarize existing research to help answer the question: "What are laypeople´s myths regarding pedophilia and CSA?"

METHODS

This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify as many relevant articles as possible. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost databases for articles published before January 2022. Sixty-one articles were included in the current review.

RESULTS

Overall, findings revealed a significant number of myths regarding pedophilia and CSA, organized into the following categories: (i) blame diffusion, (ii) denial of abusiveness, (iii) restrictive stereotypes, (iv) victim age and consequences, (v) social stigma, (vi) punitive attitudes, and (vii) treatment.

CONCLUSION

Findings suggested that laypeople's perceptions should be taken into account when devising prevention policies. Additionally, perceptions should also be a target of prevention since there is evidence of social stigma and prejudice involving individuals with pedophilia. Such phenomena can contribute to social, emotional, and cognitive problems, among said individuals as well as causing these individuals to exhibit a higher risk for abusive behavior and less help-seeking. Glina F, Barroso R, Cardoso D, et al. Lay People´s Myths Regarding Pedophilia and Child Sexual Abuse: A Systematic Review. Sex Med Rev 2022;XX:XXX-XXX.

Determinants of Sexual Abuse Prevention Knowledge among Children’s Schools in West Java Indonesia: A Cross-Sectional Study

Child sexual abuse (CSA) is a severe problem in Indonesia. Adequate knowledge in children about CSA prevention is essential so that children do not become victims. Lack of adequate children’s knowledge of the prevention of CSA may put them at risk for experiencing CSA. This cross-sectional study explores the association factors between knowledge and characteristics regarding the prevention of CSA. The study was conducted in Bandung Regency, West Java, Indonesia. Students from grades two to nine at two elementary schools were eligible for the study. Results showed that as sources of information associated with better knowledge of CSA prevention (p = 0.00), teachers and parents significantly contributed to CSA information. Multivariate analysis showed that teachers (OR: 33.479, 95% (CI: 4.467–250.912)) and parents (OR: 45.336, 95% (CI: 10.886–188.807)) significantly contributed as a source of CSA information among students. The findings are essential important implications for interventions intended at preventing CSA. Sexual education programs should be officially applied at schools for children with the support of their parents and teachers.

Effectiveness of school-based child sexual abuse intervention among school children in the new millennium era: Systematic review and meta-analyses

Introduction

School-based child sexual abuse intervention programs were developed to educate the school children to protect them from sexual abuse. The programs were evaluated to make sure the interventions were effective in reducing child sexual abuse cases (CSA). This review aimed to determine the effectiveness of the school-based child sexual abuse intervention programs in the new millennium era (2000-2021) in improving the knowledge, skills, and attitude of school children under 18 years old toward child sexual abuse.

Methods

A systematic search was conducted through MEDLINE (PubMed), EBSCO, and SCOPUS databases to collect full English articles related to school-based CSA intervention programs published from 2000 to 2021.

Results

A total of 29 studies from randomized control trial and quasi-experimental from several countries was analyzed. Comparisons within group of pre-post intervention for knowledge, skills, and attitude were measured by standardized mean difference (SMD) and 95% CI of -1.06 (95% CI: -1.29, -0.84), -0.91 (95% CI: -1.2, -0.61), and -0.51 (95% CI: -3.61, 0.58), respectively. Meanwhile for between intervention and control group comparisons, the SMD of knowledge was 0.9 (95% CI: 0.63, 1.18), skills was 0.39 (95% CI: 0.07, 0.71), and attitude was 1.76 (95% CI: 0.46, 3.07).

Conclusion

The programs were found to be effective in improving the knowledge, skills, and attitude of the students from pre-intervention to post-intervention and between the intervention and control groups.Systematic Review Registration: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022312383, identifier: CRD42022312383.

Child sexual abuse detection in the pediatric emergency room

BACKGROUND

Children who report sexual abuse are often first evaluated in a Pediatric Emergency Room (ER).

OBJECTIVE

This study aims to describe clinical characteristics and management among these children.

PARTICIPANTS AND METHODS

A retrospective review of child sexual abuse (CSA) cases in the ER of a tertiary hospital in Madrid over a 9-year period (January 2011 to April 2020) was conducted. 213 children up to 16 years old were included. Descriptive statistics were performed.

RESULTS

An 83% of victims were girls, of whom 97.7% reported physical contact. The mean age was 8.5 ± 4.4 years, with two peaks of incidence at ages of 3 and 13. Aggressors were known by the victim in 77.8% of cases. Anogenital lesions were present in 39.9% of children who described physical contact, of which 31.7% were suspicious or specific of CSA. We obtained positive microbiological samples in 41 patients, with 14.6% specific findings for sexually transmitted infections (STIs). 23,9% received prophylaxis for bacterial STIs and 13.6% against HIV. 59.6% were followed-up in outpatient clinics. Since our protocol renovation in 2019, we observe a statistically significant increase in microbiological detection (p < .005) and outpatient follow-up (p < .001).

CONCLUSIONS

STIs screening should always be done when physical contact is reported for eventual treatment and perpetrator prosecution, as physical lesions are frequently not found. The optimal treatment of CSA requires the use of renewed specific protocols and the involvement of multidisciplinary trained teams to ensure adequate medical and personal care.

Trapped in a Maze: Arab Teachers in Israel Facing Child Sexual Abuse Among Their Pupils

Cultural contexts are formative of and fundamental to how individuals understand, conceptualize, and act within a context of violence. Conceptually and methodologically, however, research from a culturally informed perspective on the experiences of teachers contending with the violence of child sexual abuse (CSA) in particular is broadly limited. As educators frequently confront cases of CSA in their everyday work, their ability to promote detection, disclosure intervention, and especially prevention gives them the potential to be agents of social change; however, while their responsibilities are critical, they are simultaneously members of their communities and cultures, and their interactions are bound by these dynamics. The purpose of the study is to analyze the experiences of Arab teachers in Israel who confront CSA in their everyday work. The findings are based on qualitative thematic analysis of semi-structured interviews conducted with 30 female Arab teachers working within the Arab school system in Israel. Results indicate that when facing CSA, the teachers experience an ongoing conflict between their cultural and professional codes, trapping them in a maze of intertwining and oppositional demands. On the one hand, they are constrained by the norm of protecting the honor and maintaining the status and reputation of those involved, including themselves; on the other hand, as empathetic professionals, they desire to aid their pupils. While the participants do not accept the status quo, they are effectively at a loss as to how to change it. In order find a way out of their entrapment in coping with CSA among their pupils, the only currently available path is to act as a lone hero; there is, however, the potential to foster the development of a secondary culture within the school to inaugurate cultural change in coping with CSA. Implications for future research, policy, and practice are discussed.

A multidisciplinary approach in pre-pubertal child sexual assault cases - forensic evaluation and suggestions

BACKGROUND

Child sexual assault is highly prevalent in India yet a handful cases are reported under POCSO (Protection against child sexual offenses) Act, 2012. Even though the victims' testimony alone is enough to arrest accused as regulated by the Supreme Court but forensic evidence is still critical for sentencing rapists. A systematic evaluation of such cases will estimate impact of Child sexual assault (CSA) and pinpoint important aspects required for progression of prevention strategies and provision of support.

METHOD AND OBJECTIVE

Present study reviewed cases pertaining pre-pubertal victims (up to 10 years age). Study included simple descriptive analysis of data highlighting significance of different variables in sexual assault cases involving child victims- perpetration, interventions, medical examination and forensic DNA analysis with the aim to improve primary preventive strategies and identify potential setbacks obstructing road to justice.

RESULT

The strengths and weaknesses of pre-pubertal sexual assault assessment were identified. This study analyzed socio-economic backgrounds, age of alleged accused and whether known to the victim. Frequently reported type of abuse was assessed and total reviewed cases that yielded DNA profile from exhibits of victims and alleged accused were determined.

CONCLUSION

As emerged in present study, pre-pubertal CSA is a complicated phenomenon grounded in interplay between societal influences, family support, evidence collection, legal delays, and medical hindrances that greatly affect DNA analysis. Prevalence of CSA is evidently alarming and demands stringent measures to be taken to prevent and control it. Joint and multidisciplinary assessment is important for forensic reporting rather than solo assessment.

Psychological Aspects of Child Maltreatment

In this review, we provide information about the etiology, risk factors, and clinical presentations of maltreatment to help clinicians better understand child abuse and neglect. Child maltreatment is a major global health challenge that can result in severe consequences. Abused and neglected children are likely to develop psychiatric disorders, such as major depressive disorder, anxiety disorder, and posttraumatic stress disorder. Understanding child maltreatment is expected to prevent and reduce victimization in children, adolescents, and their families.

Multi-type childhood maltreatment exposure and substance use development from adolescence to early adulthood: A GxE study

BACKGROUND

Childhood maltreatment types can co-occur and are associated with increased substance use during adolescence and early adulthood. There is also a strong genetic basis for substance use which interacts with environmental factors (e.g., childhood maltreatment) to influence substance use phenotype.

OBJECTIVE

This research aimed to identify childhood maltreatment sub-groups based on type and chronicity, and their association with substance use change from adolescence to early adulthood, while accounting for the influence of substance use polygenic risk (i.e., genetic risk based on the combined effects of multiple genes).

PARTICIPANTS

We used a sample of unrelated European-origin Americans with genetic and childhood maltreatment data (n = 2,664) from the National Longitudinal Study of Adolescent to Adult Health.

METHODS

Latent profile analysis was used for sub-group identification and direct and interaction effects were tested for longitudinal trajectories of substance use utilizing generalized estimating equations.

RESULTS

Three sub-groups with co-occurring childhood maltreatment exposures were identified: a high sexual abuse sub-group, a high physical abuse sub-group, and a normative sub-group (with low maltreatment exposure). At high polygenic risk, the high physical abuse sub-group had faster increases in substance use over time. In comparison, the high sexual abuse sub-group had faster progression in substance use only at low and medium polygenic risk.

CONCLUSIONS

Findings provide initial evidence for biological and environmental differences among maltreatment sub-groups on trajectories of substance use.

Past is present: Pathways between childhood sexual abuse and relationship satisfaction

Research on childhood sexual abuse (CSA) has consistently demonstrated the damaging effects of these experiences, not only on survivors' development, but also on the nature and quality of their adult relationships, particularly romantic ones. Yet, research to date has not demonstrated a strong direct effect of CSA on relationship satisfaction. This study examined the pathways from CSA to relationship satisfaction via sexual shame and romantic partner attachment. Data collected through surveys from 732 adults were analyzed using a serial mediation model. As expected, the direct association between CSA and relationship satisfaction was statistically significant but rather weak. Results demonstrated that sexual shame, combined with either romantic partner attachment avoidance or romantic partner attachment anxiety, reduces relationship satisfaction. Specifically, three possible pathways mediated by sexual shame were identified. Implications of the findings are discussed and recommendations for clinical interventions with CSA survivors that address sexual shame and romantic partner attachment are provided.

Edutainment as A Strategy of Child Sexual Abuse Prevention: Literatur Review

BACKGROUND: Child sexual abuse is the most serious public health problem in all cultures and societies that will have an impact in the future on a lost generation. The United Nations Children's Fund (UNICEF) estimates that around 120 million girls under 20 y.o. have been sexually abused. AIM: This study aimed to determine the effectiveness of preventing sexual abuse in children by using an edutainment approach. METHODS: This study used an online journal database that provided free articles and journals in PDF such as Proquest, Google Scholar, Pubmed, Elsevier, and Scinapse. Literature was collected from the past 10 years, 2010–2020, using the following keywords: Edutainment, Child Sexual Abuse, Child Sexual Abuse Prevention, and Child Sexual Abuse Education Program. RESULTS: This study examining the effectiveness of edutainment in preventing child sexual abuse showed that edutainment in preventing child sexual abuse through children's play had succeeded in increasing awareness about sexual abuse in children and parents, as well as improving children's self-protection skills to recognize potential situations of abuse and resist inappropriate touch requests. CONCLUSIONS: Intervention model with edutainment approach effective for the prevention of child sexual abuse

"Mental Health Problems in Abused Institutionalised Serbian Adolescents and Their Use of Social and Mental Health Services"

"The aim of the study was to determine the frequency of various forms of maltreatment in adolescents without parental care, their mental health problems and treatment needs. Sixty examinees of both genders, aged 12-18, were divided in two groups: abused group (adolescent without parental care in an institutional setting) and control group (general population). The presence/absence of registered abuse/neglect by official social services were the criterion for classifying respondents into groups. The general questionnaire, Childhood Trauma Questionnaire and Youth Self Report were used. 46.67% of adolescents were neglected, 40% of them suffered several types of abuse, 10% were physically abused, 3.33% were emotionally abused, and no adolescent was sexually abused. 16.6% of cases of sexual abuse in the abused group as well as milder forms of maltreatment in the control group were registered by self-reported retrospective measures, which are not part of official registers. Delinquency, aggressive behavior and somatic complaints are significantly more prominent in the abused group compared to the control group. 86% of adolescents used some form of support and counseling from professionals, 56.6% were included in psychiatric treatment, and only 36.6% in psychotherapy. Mental health problems in abused adolescents without parental care indicates the specific needs for psychotherapy and psychiatric treatment."

Epidemiology of Child Maltreatment during the COVID-19 Pandemic in Saudi Arabia

Child maltreatment, especially during health crises, is a major public health issue transcending cultural, social, and racial contexts. We assessed the sociodemographic and related risk factors associated with the types and rates of child maltreatment. We also assessed the economic, social, and environmental characteristics of child maltreatment victims and their perpetrators, as they were reported to the Saudi National Family Safety Program (NFSP), with consideration of the COVID-19 pandemic’s impact. A secondary data analysis of a retrospective review was conducted to compare types and rates before and during the COVID-19 outbreak, utilizing descriptive and multivariate analyses on anonymized data from the NFSP. According to a predetermined list of relevant risk factors for child maltreatment outlined by the NFSP, these anonymized data were obtained and analyzed with no exclusion criteria (n = 1304). The findings showed that a child’s age correlated significantly and positively with their odds of being physically maltreated; as a child’s age increased by one year, on average, their corresponding predicted odds of being physically maltreatment tended to rise by a factor equal to 7.6% (p < 0.001). Neglected children, compared to those who had not been previously neglected, were predicted to be almost twice (2.23 times more) as likely to be victims of physical maltreatment on average (p < 0.001). Children were notably more likely to experience sexual abuse during the COVID-19 pandemic than those exposed to abuse during the period before (1.69 times). The COVID-19 pandemic was associated with significantly lower odds of physical child maltreatment (47.7% less). This study found no statistically significant effect of the COVID-19 pandemic on children’s odds of being emotionally maltreated (p = 0.169). These findings support the existence of specific risk factors for child maltreatment for both child victims and perpetrators. They also attest to the significant differences between different types of maltreatment. A systematic, proactive system is needed to screen and document child maltreatment with a higher degree of integration with community reporting systems.

Evaluation of Juvenile and Adolescent Sexual Abuse Victims: A Retrospective Study

OBJECTIVE

This study aimed to evaluate the sociodemographic characteristics and the mental, anogenital, and physical examination findings of child and adolescent sexual abuse victims and to discuss them in the light of the literature.

MATERIALS AND METHODS

This study included a total of 134 children and adolescent cases between the ages of 0 and 18 who were victims of sexual abuse, from among the reports prepared in the Forensic Medicine Clinic of Bolu Abant Izzet Baysal Training and Research Hospital between 2015 and 2019.

RESULTS

This study included 134 cases: 113 (84.3%) were female and 21 (15.7%) were male. The mean age was 13 ± 3.4 years (min: 3, max: 17). The average age of the defendants was 25.6 ± 13 years (min: 12, max: 75), and all the defendants were male. The defendants were strangers in 60 cases (4.8%). Sexual abuse mostly occurred as vaginal penetration in 46 cases (34.3%). Sixty-nine (51.5%) cases were exposed to abuse more than once. Depression due to sexual abuse developed in 14 (10.4%) of the cases.

CONCLUSION

Considering that many child abuse victims have normal examination findings, it should not be forgotten that the interview and psychiatric examination with the child are as valuable as the genital examination.

Prevalence of adult sexual abuse in men with mental illness: Bayesian meta-analysis

BACKGROUND

Sexual abuse is a broad category of traumatic experiences that includes rape and any unwanted sexual contact with a body part or foreign object, whether penetrative, oral or otherwise. Although patients with mental illness have a higher risk of becoming victims of sexual abuse in adulthood, few studies investigate the proportion of male victims in this population. Their underrepresentation in research is a barrier to understanding the negative outcomes associated with sexual abuse in men.

AIMS

We estimated the prevalence of recent (past year) and adulthood sexual abuse perpetrated by any perpetrator and separately by intimate partners in males diagnosed with a mental illness.

METHOD

To model the prevalences and heterogeneity arising from reports, we used Bayesian multilevel models. Prevalences were estimated for mixed-diagnosis, substance misuse, intellectual disability and post-traumatic stress disorder samples, and studies reporting specifically on intimate partner violence. This review was registered through PROSPERO (CRD42020169299).

RESULTS

Estimated adult sexual abuse was 5.3% (95% Credibility Interval 1.6-12.8%) for past-year abuse and 14.1% (95% Credibility Interval 7.3-22.4%) for abuse in adulthood. There was considerable heterogeneity of prevalence between studies and diagnosis groups.

CONCLUSIONS

Our analyses show that the prevalence of sexual abuse of males diagnosed with a mental illness was much higher than for men in the general population. This has important implications regarding the proportion of undetected or untreated sexually abused men in clinical practice.

Prevalence of sexual abuse and its association with health-risk behaviors among Brazilian adolescents: A populational study

BACKGROUND

Analysis of sexual abuse has usually been neglected in research at developing countries despite its everlasting consequences. This study examined the prevalence of sexual abuse among Brazilian adolescents according to data from the National School Health Survey (PeNSE) and analyzed it based on Brazilian regions, sociodemographic aspects, health information, and health-risk behaviors among Brazilian adolescents who reported having experienced sexual abuse previously.

PARTICIPANTS AND SETTING

The PeNSE data were utilized, and the sample included 102,072 students from all over Brazil, aged between 11 and 19 years.

METHODS

Data were collected by questionnaires and were analyzed by multivariate analysis using the Poisson regression model.

RESULTS

The results denoted a relation between sexual abuse, social determinants of health variables (i.e., black, indigenous, and mixed skin color/ethnicity; Brazilian region public school, age between 15 and 18 years, and low education level of the mother), and health-risk behaviors (i.e., early sexual intercourse, having multiple sexual partners, unprotected sexual intercourse, use of tobacco, alcohol, and illicit drugs).

CONCLUSION

Therefore, reports of sexual abuse are associated with risky behaviors. Given these findings, targeted interventions on sexual abuse are essential for the health of adolescents and the prevention of risky behaviors, and can also facilitate programs to prevent sexual abuse.

Longitudinal associations between childhood sexual abuse-related PTSD symptoms and passive and active suicidal ideation among sexual minority men

BACKGROUND

Sexual minority men report high rates of childhood sexual abuse (CSA) and adulthood suicidality. However, mechanisms (e.g., PTSD symptoms) through which CSA might drive suicidality remain unknown.

OBJECTIVE

In a prospective cohort of sexual minority men, we examined: (1) associations between CSA and suicidal thoughts and behaviors; (2) prospective associations between CSA-related PTSD symptoms and suicidal ideation; and (3) interpersonal moderators of these associations.

PARTICIPANTS AND SETTING

Participants included 6305 sexual minority men (M_age = 33.2, SD = 11.5; 82.0% gay; 53.5% White) who completed baseline and one-year follow-up at-home online surveys.

METHODS

Bivariate analyses were used to assess baseline demographic and suicidality differences between CSA-exposed participants and non-CSA-exposed participants. Among CSA-exposed participants, multivariable logistic regression analyses were used to regress passive and active suicidal ideation at one-year follow-up on CSA-related PTSD symptoms at baseline. Interactions were examined between CSA-related PTSD symptoms and interpersonal difficulties.

RESULTS

CSA-exposed sexual minority men reported two-and-a-half times the odds of suicide attempt history compared to non-CSA-exposed men (95% CI = 2.15-2.88; p < 0.001). Among CSA-exposed sexual minority men, CSA-related PTSD symptoms were prospectively associated with passive suicidal ideation (adjusted odds ratio [aOR] = 1.38; 95% CI = 1.19; 1.61). Regardless of CSA-related PTSD symptom severity, those with lower social support and greater loneliness were at elevated risk of active suicidal ideation at one-year follow-up.

CONCLUSIONS

CSA-related PTSD symptom severity represents a psychological mechanism contributing to CSA-exposed sexual minority men's elevated suicide risk, particularly among those who lack social support and report loneliness.

PFSA DNA database: A tool to hunt the serial offenders

A forensic DNA database comprises of thousands of DNA profiles generated from suspects, convicts or even from common people from society. It is used for the cross-matching of DNA profiles obtained from evidence items collected from a crime scene. These databases are playing a core role in clearing the innocent and solving the dead-end unresolved crimes ultimately leading to crime reduction. In March, 2017, a nine years old minor girl was raped in district Khushab (Province Punjab). The medico-legal examiner indicated brutal sexual violence on the victim. Police apprehended a suspect who was excluded as the source of foreign male DNA from tested evidence items. Thus the case put up a question mark on the capabilities and efficiency of the police. An unknown male DNA profile obtained from evidence items was uploaded to PFSA DNA Database to maintain record. Later on, a suspect was arrested by Karachi (Province Sindh) police in another rape case, DNA profile of suspect was searched in the PFSA DNA Database. This generated DNA profile matched with the foreign DNA profile obtained from evidence items of minor victim, hence this atrocious crime was resolved. PFSA DNA Database provides support to criminal prosecution and also leads to identify potential suspects. It took years of effort to develop the rich PFSA DNA Database which subsequently proved to be fruitful in the exoneration of innocents and conviction of offenders in criminal cases.

Access to Healthcare for Minors: An Ethical Analysis of Judgments of the European Court of Human Rights

The right to non-discriminatory access to healthcare is anchored in the European Convention on Human Rights and other international treaties or guidelines. Since its ratification, the European Convention on Human Rights was made binding in all Member States of the Council of Europe and is interpreted by the European Court of Human Rights (ECtHR). Despite its legal recognition, discrimination in healthcare provision has repeatedly been an issue of medicoethical and political consideration. In this context, minors are particularly in danger of being deprived of this fundamental right. The aim of this study is to analyze the current state of the ECtHR jurisdiction on challenges in accessing healthcare for minor patients. We conducted a systematic search of judgments by the ECtHR using the keywords "healthcare" and "child". We performed descriptive statistics and qualitative thematic analysis. Our search resulted in n = 66 judgments, which were all screened. Access to healthcare for minors played a role in n = 21 judgments, which involved applications against n = 13 countries. We formed five, partially overlapping categories, which represent recurring themes regarding the research topic. These themes are governance failure (n = 11), the status of refugee, asylum seeker or migrant (n = 5), parental home (n = 5), maternity and birth (n = 4) and others (n = 2). The normative framework of the ECtHR's jurisprudence illustrates intersections between social, legal and medicoethical aspects of minors' discrimination in the healthcare system. It emphasizes the particular vulnerability of children, who require exceptional protection. Inadequate access to healthcare manifests itself in specific situations, such as in the context of migration or staying in public institutions. Healthcare professionals need to be sensitized for such discrimination mechanisms, as they are often at the forefront of encountering structural discrimination in the healthcare system.

Care of women and girls after sexual assault in Geneva: A descriptive study between 2005 and 2014

BACKGROUND AND PURPOSE

We aimed to examine epidemiological data and identify risk factors for sexual assault. This study included women seeking care at the Geneva University Hospitals emergency obstetrics and gynaecological unit.

METHOD

Retrospective, sociodemographic, and clinical data were collected from the medical reports.

RESULTS

We reviewed 836 medical charts and registered 92.8 women and girls per year who consulted the emergency department after sexual assault. The average age was 26 (±12) years, with a median of 23 years. Body lesions were reported in 525 patients (63%) and genital traumatic lesions were reported in 230 (28%) patients. Sexual assault by a stranger was reported in 436 cases (52%). Thirty percent of patients knew their aggressor. Aggressions were predominantly committed on the weekend, accounting for 367 cases (46%), with nearly two-thirds (65%, n = 474) occurring between 10 pm and 6 am. In total, 399 (48%) patients who were sexually assaulted reported having consumed alcohol and 102 (12%) reported having taken drugs prior to the aggression; 80 (10%) patients had consumed both and 286 (34%) had amnesia. Half of the sample sought and received medical care within 24 h from the time the aggression took place.

CONCLUSION

Sexual assault risk factors in our study population in Geneva included use of drugs and alcohol, with amnesia. Future prevention and education interventions should target these areas.

Lessons Learned: Creation and Testing of a New Instrument (Sex Offenders Grooming Assessment) for Measuring Sex Offenders' Perceptions of Their Grooming Behaviors

Grooming is a process whereby an individual who plans to commit a sexual crime uses deception with the victim as well as the people in the environment (such as the victim's family members, the offender's family, etc.) so that the crime goes undetected. Despite the overwhelming presence of grooming in sexual crimes, there is a dearth of research on sex offenders' perceptions of their own grooming behaviors. This paper describes the psychometrics and lessons learned in the pilot study of testing and revising a new instrument for measuring sex offenders' perceptions of their grooming behaviors (Sex Offenders Grooming Assessment; SOGA), with a sample (n = 50) of convicted male sex offenders in community based specialized therapy. Analyses suggest that using behaviorally-specific questions yielded more reliable results than general categorical grooming questions. Understanding how sex offenders perceive and report their grooming behavior provides valuable insight critical to treatment and assessment.

Boys should not be overlooked: Sexual violence victimization and associated factors among school-going adolescents in urban Ghana

BACKGROUND

Adolescent sexual violence victimization is still less researched in countries within sub-Saharan Africa, including Ghana.

OBJECTIVES

To estimate the 12-month prevalence of sexual violence victimization and describe the differences and commonalities in the associated factors between school-going boys and girls in urban Ghana.

PARTICIPANTS AND SETTING

Students (n = 1692) aged 13-19 years attending Second Cycle Schools in the Greater Accra Region of Ghana participated in this study.

METHODS

This is a cross-sectional survey involving the use of a self-report anonymous questionnaire. Items measuring sexual violence victimization and correlates were adopted from the 2012 WHO-Global School-based Student Health Survey. Data analysis involved bivariable and multivariable approaches.

RESULTS

Overall, 17.6% (95% confidence interval [CI] 15.7, 19.4) adolescents (males = 10.4% [95% CI 8.3, 13.6]; females = 24.3% [95% CI 21.5, 27.3]) reported sexual violence victimization during the previous 12 months. Girls (compared to boys) were nearly three times more likely to report sexual violence victimization (aOR = 2.74, 95% CI 2.01, 3.74, p < 0.001). Breakup, sexual minority status, and conflict with parents were uniquely associated with sexual violence victimization among females. Regardless of gender, adolescents who were in a romantic relationship (aOR = 1.63, 95% CI 1.19, 2.24, p = 0.002) and reported physical abuse victimization (aOR = 1.84, 95% CI 1.36, 2.49, p < 0.001) were more likely to report sexual violence victimization.

CONCLUSIONS

The prevalence of sexual violence victimization among school-going adolescents in urban Ghana compares with estimates from sub-Saharan Africa, but also warrants the need for universal and targeted prevention regimes against the offence in both boys and girls.

Implanting false autobiographical memories for repeated events

Research to date has exclusively focused on the implantation of false memories for single events. The current experiment is the first proof of concept that false memories can be implanted for repeated autobiographical experiences using an adapted false memory implantation paradigm. We predicted that false memory implantation approaches for repeated events would generate fewer false memories compared to the classic implantation method for single events. We assigned students to one of three implantation conditions in our study: Standard, Repeated, and Gradual. Participants underwent three interview sessions with a 1-week interval between sessions. In the Standard condition, we exposed participants to a single-event implantation method in all three interviews. In the Repeated condition, participants underwent a repeated-event implantation method in the three interviews. The Gradual condition also consisted of a repeated-event implantation method, however, in the first interview alone, we suggested to participants that they had experienced the false narrative once. Surprisingly, within our sample, false memories rates in the Standard condition were not higher compared to the Repeated and Gradual conditions. Although sometimes debated, our results imply that false memories for repeated events can be implanted in lab conditions, likely with the same ease as false memories for single events.

Victims and Perpetrators of Child Sexual Abuse: Abusive Contact and Penetration Experiences

Child sexual abuse (CSA) includes abusive contact experiences, which habitually impact the victim's whole life. This study aims to analyze the characteristics of six CSA experiences with physical contact, including penetration, in a representative sample of the Spanish population. Participants were 1071 Spanish adults (53% males; M_age: 45.37) who completed the Child Sexual Abuse Experiences Questionnaire. The victim's age at the first episode, the perpetrator's characteristics, and the number of times that each experience occurred were analyzed, taking into account gender differences. Results were reported for every experience independently. The most prevalent age at the first experience was from 6 years old onwards, but with differences in some experiences. The abuses usually happened more than once, committed by the same person. The most prevalent perpetrator is a male, although a female perpetrator is more prevalent in male victims. Most of the abuses were committed by an adult acquaintance, a strange adult, and other minors, with some gender differences. The implications of the results concerning every CSA experience are discussed, highlighting their value for future research and practice, the design of preventive programs, and early detection of CSA.

The current status of sexually transmitted infections in South Korean children in the last 10 years

OBJECTIVE

This study aimed to review the status of sexually transmitted infections (STIs) in children in South Korea between 2010 and 2019, as well as to establish guidelines for the prevention and management to reduce the incidence of STIs in children.

METHODS

Data reports from 590 STI surveillance institutions in local health center, hospital-level medical institutions with urology or obstetrics/gynecology departments and public hospitals between 2010 and 2019 in the integrative disease management system of the Korea Disease Control and Prevention Agency as of December 2020 were analyzed.

RESULTS

A total of 172,645 cases of STIs were reported over the 10-year period (2010-2019), of which 2,179 cases (1.26%) represented STIs in children below the age of 18 years. A higher incidence of infections was observed in girls (1,499 cases, 68.79%) than in boys (680 cases, 31.21%). The STIs that had the highest incidence were, in descending order, chlamydial infections (997 cases, 45.75%), gonorrhea (592 cases, 27.17%), condyloma acuminata (338 cases, 15.51%), genital herpes (250 cases, 11.47%), and chancroid (2 cases, 0.09%). In adolescents aged 14 to 17 years, chlamydial infections, genital herpes, and gonorrhea were most frequently reported. Condyloma acuminata, in particular, have been consistently reported in children below the age of 14 years.

CONCLUSION

Children must be protected legally and institutionally from sexual abuse. Specific management protocols for STIs in children must be established by local governments and associated organizations. National human papillomavirus vaccination programs should be expanded to include boys, and anti-STI educational efforts using modern media should be more activated.